Aug 2026· European Journal of Obstetrics, Gynecology, and Reproductive Biology· Vol 326, pp.
115363
· 0 citations· 26 references
Medicine
TL;DR
Cervical cancer burden attributable to unsafe sex showed the highest DALY rate among females aged 50-69 years and the highest mortality rate among those aged 70 years or older, and overall, cervical cancer burden exhibited an inverse association with SDI.
Abstract
Background
Despite global elimination initiatives, cervical cancer remains a major public health burden across Asia. We aimed to assess regional and age-specific trends in cervical cancer burden using data from the Global Burden of Disease Study (GBD) 2023.
Methods
We analyzed GBD 2023 to estimate the burden of cervical cancer across 34 Asian countries from 1990 to 2023. Age-standardized incidence rate (ASIR), mortality rate (ASMR), and DALY rate (ASDR) were assessed by region and Socio-demographic Index (SDI), while age-specific rates were evaluated for females aged 15-49, 50-69, and ≥70 years. Cervical cancer was defined as malignant neoplasm of the cervix, and burden attributable to unsafe sex and tobacco use was estimated using population-attributable fractions derived from exposure data and relative risks. Estimates are presented as means with 95% uncertainty intervals (UIs).
Results
In 2023, South Asia exhibited the highest cervical cancer burden, with an ASIR of 22.07 (95% UI, 14.68-33.20) per 100,000 population, whereas High-income Asia Pacific had the lowest ASIR at 11.89 (9.94-14.37). A similar pattern was observed for ASDR: South Asia had the highest rate at 377.19 (95% UI, 255.79-558.38) per 100,000 population, while High-income Asia Pacific exhibited the lowest rate at 96.04 (84.08-109.75). From 1990 to 2023, ASIR and ASDR generally declined across Asia, although substantial regional disparities persisted. Across all five regions, the relative contribution of females aged 15-49 years to cervical cancer burden increased, while that of older age groups generally decreased; however, the absolute incidence rates among females aged 15-49 years increased only in Southeast Asia and High-income Asia Pacific. Cervical cancer burden attributable to unsafe sex showed the highest DALY rate among females aged 50-69 years and the highest mortality rate among those aged 70 years or older. Overall, cervical cancer burden exhibited an inverse association with SDI.
Conclusion
Cervical cancer remains a substantial burden in low-SDI Asian countries, with an increasing relative contribution among females aged 15-49 years. Age-specific and context-specific prevention strategies are urgently needed to reduce inequalities and accelerate elimination efforts in Asia.
OBJECTIVE
Cervical cancer remains a critical global health threat. Despite its member states accounting for more than 85% of global gross domestic product (GDP), no comprehensive assessment of cervical cancer burden exists across the diverse Group of Twenty (G20) economies. This study aimed to characterize long-term cervical cancer burden trends and project future epidemiological trajectories among G20 reproductive-age females.
METHODS
Using Global Burden of Disease 2021 data, we analyzed cervical cancer disability-adjusted life years (DALYs) among females aged 15-49 years in G20 countries (1990-2021) via Joinpoint regression, health inequality indices, Das Gupta decomposition, and Bayesian age-period-cohort projection to 2035.
RESULTS
In 2021, cervical cancer generated 2.27 million DALYs among G20 reproductive-age females, with age-standardized rates ranging from 24.89 (Saudi Arabia) to 667.65 (South Africa) per 100,000. Overall rates declined (annual average percent change [AAPC]=-1.40%) (1990-2021), with China achieving a notable reduction (AAPC=-1.51%), but increased in Russia (AAPC=1.70%), Japan (AAPC=0.65%), Italy (AAPC=0.33%), and South Africa (AAPC=0.14%). Sociodemographic Index (SDI)-related inequality narrowed (1990: Slope Index of Inequality [SII]=-349.58, Concentration Index=-0.21; 2021: SII=-261.82, Concentration Index=-0.18), but persisted. Population growth (+23.99%) and age structure changes (+20.92%) drove DALY increases in the G20, offset by epidemiological improvements (-43.92%). Most G20 countries will see declining burden by 2035, while South Africa faces the largest increase.
CONCLUSION
Differentiated, evidence-based strategies tailored to national burden characteristics, addressing demographic shifts, key health system gaps, and human papillomavirus genotype disparities, are critically needed to successfully achieve the World Health Organization 2030 global cervical cancer elimination targets.
Xiang-Wen Li, Siyu Pan, Peng-Fei Qu et al.· Journal of Gynecologic Oncol...· 0 citations
Background Colorectal cancer (CRC) represents a major global health burden, with modifiable risk factors including high body-mass index, insufficient physical activity, tobacco use, and dietary risks contributing substantially to its incidence and mortality. However, comprehensive spatiotemporal analyses of this burden, particularly within Brazil, Russia, India, China, and South Africa (BRICS) countries, remain limited. This study aimed to assess the global, regional, and national burden of CRC attributable to these four modifiable risk factors from 1990 to 2021 using Global Burden of Disease Study 2021 data. Methods Data from 204 countries and territories were analyzed to estimate attributable CRC burden, stratified by sex, age, region, and country. Temporal trends were assessed, projections to 2050 were generated using autoregressive integrated moving average and exponential smoothing models, and health inequalities across Socio-demographic index (SDI) levels were evaluated using the Slope Index of Inequality and Concentration Index. Results In 2021, males in BRICS countries exhibited higher attributable CRC burden. Age-standardized rates decreased in high-SDI regions but increased in low-SDI regions. Between 1990 and 2021, absolute attributable CRC cases increased across all BRICS countries, although age-standardized trends varied. Projections indicated continued increases in absolute case numbers in BRICS countries by 2050. Global burden remained concentrated in low-SDI regions, with modest reductions in absolute inequalities but persistent relative inequalities. Conclusions Substantial disparities in CRC burden attributable to modifiable risk factors exist across sociodemographic contexts. Targeted, equity-oriented public health strategies are essential to mitigate the projected burden increase, particularly within BRICS countries, by 2050.
Miao Yu, Yi-Ping Lu· Journal of Gastrointestinal...· 0 citations
INTRODUCTION
Tobacco smoking is a major modifiable risk factor for bladder and kidney cancer. In Latin America and the Caribbean (LAC), comprehensive longitudinal evidence on the smoking-attributable burden of these cancers remains limited. This study assessed the burden, temporal trends, socioeconomic inequalities, and future projections of smoking-attributable bladder and kidney cancer in LAC.
METHODS
Data were obtained from the Global Burden of Disease (GBD) 2023 study to estimate deaths, disability-adjusted life years (DALYs), age-standardized mortality rate (ASMR), and age-standardized DALYs rate (ASDR) for smoking-attributable bladder and kidney cancer across 33 countries and territories in Latin America and the Caribbean from 1990 to 2023. Temporal trends were evaluated using joinpoint regression and average annual percent change (AAPC). Socioeconomic inequalities were assessed in relation to the sociodemographic index (SDI) using the slope index of inequality (SII) and concentration index (CIX). Future burden to 2050 was projected using a Bayesian age-period-cohort model.
RESULTS
In 2023, smoking-attributable bladder cancer caused an estimated 1742 deaths and 35903 DALYs in LAC, while kidney cancer caused 637 deaths and 14947 DALYs. From 1990 to 2023, ASMR and ASDR for both cancers showed overall declining trends, although substantial regional heterogeneity was observed, with the Caribbean showing increasing burden. At the national level, the burden of both cancers was positively associated with SDI in 2023. Projections to 2050 indicate that age-standardized rates will continue to decline, whereas the absolute numbers of deaths and DALYs will increase.
CONCLUSIONS
Age-standardized rates declined overall, whereas the absolute numbers of deaths and DALYs are projected to increase in Latin America and the Caribbean. Stronger tobacco control and better-prepared health systems are needed to address the growing cancer burden in aging populations.
OBJECTIVE
Cervical cancer remains a major public health challenge among women in China. This study aimed to comprehensively assess long-term trends and future projections of cervical cancer burden in China.
METHODS
Data on cervical cancer in China from 1990 to 2023 were extracted from Global Burden of Disease Study2023. Prevalence, incidence, deaths, years lived with disability (YLDs), years of life lost (YLLs), disability-adjusted life years (DALYs), and age-standardized rates (ASRs) were analyzed. Temporal trends were evaluated using estimated annual percentage change (EAPC) and Joinpoint regression. Das Gupta decomposition quantified the contributions of population growth, aging, and epidemiological change. Nordpred was used to project deaths and DALYs from 2024 to 2045.
RESULTS
From 1990 to 2023, prevalent cervical cancer cases increased from 445,795 (95% uncertainty interval [UI]=301,749-642,609) to 752,306 (95% UI=481,273 to 1,011,544). YLDs increased by 62%, whereas YLLs decreased by 4%. Overall DALYs decreased slightly from 1,457,115 (95% UI=1,070,025 to 2,064,940) to 1,430,054 (95% UI=896,628 to 1,874,757), while deaths increased by 16%. Age-standardized DALYs rate (ASDR) declined from 294.14 to 132.72 per 100,000 population, with an EAPC of -2.43 (95% confidence interval=-2.54 to -2.33). Decomposition showed that population aging and growth offset favorable epidemiological changes, and projections suggested continued declines in ASDR with relatively stable deaths through 2045.
CONCLUSION
Despite sustained declines in ASRs, the absolute burden of cervical cancer in China remains considerable due to demographic shifts. These findings underscore the urgent need to strengthen human papillomavirus vaccination coverage and expand equitable cervical cancer screening programs.
Chao Ma, P. Yin, Nan Hong· Journal of Gynecologic Oncol...· 0 citations
The study indicates that skin cancer remains an important public health issue worldwide and countries and regions should attach great importance to the prevention and treatment of skin cancers, and develop and improve preventive measures.
